Acute vertebral collapse: CT findings in benign and malignant nontraumatic cases.

PURPOSE: The value of computed tomography (CT) for differentiating benign from malignant causes of nontraumatic acute vertebral collapse (AVC) (associated with pain of less than 3 months duration) was evaluated. MATERIALS AND METHODS: The CT findings of 34 benign (osteoporotic) and 32 malignant (metastatic or myelomatous) nontraumatic AVCs were compared. RESULTS: The following CT findings were significantly more frequent in benign AVCs: cortical fractures of the vertebral body without cortical bone destruction, retropulsion of a bone fragment of the posterior cortex of the vertebral body into the spinal canal, fracture lines within the cancellous bone of the vertebral body, an intravertebral vacuum phenomenon, and a thin diffuse paraspinal soft-tissue mass (PSTM). The following CT findings were significantly more frequent in malignant AVCs: destruction of the anterolateral or posterior cortical bone of the vertebral body, destruction of the cancellous bone of the vertebral body, destruction of a vertebral pedicle, a focal PSTM, and an epidural mass. CONCLUSION: CT can help distinguish benign from malignant causes of nontraumatic AVC.

[Use of X-ray computed tomography in cervical infections]. / Apport de la tomodensitométrie dans les infections cervicales.

Infections of face and neck represent serious and potentially life threatening conditions that are sometimes difficult to differentiate from neoplastic tumours, especially in subacute clinical forms. Conventional radiographic techniques offer interest for cervical masses, except Ultra-Sonographic exam, in sites regarding vascular axes, but carries little value for evaluating their spread into the different cervical spaces. On the other hand, C.T. is valuable to precise the location and the extent and to determine its inflammatory nature by studying the fats and the aponeurosis around it. It help in the analysis of associated adjacent signs: soft tissue swelling, extensive obliteration of adjacent fats, swelling of cervical aponeurosis, thickening of adjacent muscles. These findings are documented by the study of fourteen patients, admitted in St-Antoine hospital. All abscesses, except one, were easy to diagnose because of their low central attenuation. False negative cases are possible and noted by other authors. So, in absence of response to appropriate therapy, surgery is necessary to eliminate a misdiagnosed abscess. Furthermore, it's sometimes possible to suspect an etiology (foreign body, tuberculosis).